Involvement of the liver has been thought to be rare in patients with Wilms' tumor, but it has not been rare in our patients. Liver metastases occurred in 14.4% of our patients and they occrred in 26.7% of patinents with recurrence. The most common periods for the diagnosis of liver metastases are the first few months of the illness, the period immediately after stopping chemotherapy, or any time that lung metastases are identified. Liver ultrasonography is recommended at the initial investigation every three months for the first two years, and abnormal cases should be subjected to computed tomography or angiography. Chemotherapy and radiation therapy are not very effective, and early detection and surgical treatment are needed to obtain a cure. Generally the prognosis is very poor and we have observed a cure in only one out of four patients.
